Fibromyalgia Syndrome (FMS) affects 3-6
million individuals of which 90% are women between ages 40 and 60
years. It is the 3rd most prevalent rheumatologic
disorder after osteoarthritis and rheumatoid arthritis.
The word “fibromyalgia” is a
combination of Latin roots “fibro” (connective tissue), “my”
(muscle), “al” (pain), and “gia” (condition of). The word syndrome
simply means a group of signs and symptoms that occur together
which characterize a particular abnormality.
FMS is not a new syndrome as
it was first described in 1816. It has been called different names,
including: myalgia, fibrositis, and soft tissue rheumatism, among
others. In 1987, the American Medical Association (AMA) recognized
FMS as a true illness and a major cause of disability. The American
College of Rheumatology outlined the diagnostic criteria for
fibromyalgia in 1990.
The diagnosis of FMS is given
when no specific underlying cause can be found for the following
set of signs and symptoms. A complaint of wide-spread muscle pain
on both sides of the body, above and below the waist for at least 3
months duration. In addition, midline body pain on the spine or
chest must also be present. A physical examination that reveals at
least 11 or 18 specific tender points on the body confirms the
suspected diagnosis. Additional symptoms include tension headache,
generalized stiffness, sleep disorders, debilitating fatigue and a
high incidence of irritable bowel syndrome. Depression and
menstrual pain are also frequently reported.
The cause of fibromyalgia is
unknown, although many patients report some traumatic physical or
emotional event prior to the onset of their pain. Proposed causes
for fibromyalgia include lack of physical fitness, sleep
deprivation, chronic muscle spasm, nervous system dysfunction,
various hormonal imbalances, viral infections, aluminum toxicity,
nutritional deficiencies as well as impaired function of the
Conventional medical treatment
typically involves prescription anti-depressants, corticosteroids,
and nonsteroidal anti-inflammatory drugs (NSAIDS). The prolonged
use of these medications should be avoided as they have potentially
serious side-effects and they can also be addictive.
Several other alternative
non-drug therapies have recently shown promise in the treatment and
management of fibromyalgia syndrome. Patient education and
counseling can be effective in relieving the patient’s depression,
anxiety and anger as well as dealing more directly with stress
reduction. Moderate aerobic exercise and stretching are necessary
to reduce muscle wasting. A supervised detoxification program along
with dietary modification can improve digestive function.
The use of various nutrients
including: malic acid, magnesium, manganese, and anti-oxidants have
been shown to be beneficial in the treatment of fibromyalgia. A
more natural regimen may also include the use of herbs.
Passionflower, valerian root, and chamomile possess relaxing properties
that have been proven to be very effective in relieving muscle
tension and inducing sleep. A strong rehabilitation approach that
utilizes chiropractic adjustments, coupled with massage and
physical therapy may help patients return to their normal activities
of daily living.
The best recipe for relief of
fibromyalgia would appear to be a combination of patient education,
rest, stress reduction, moderate aerobic exercise, stretching,
nutritional intervention, and chiropractic care.